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Kid's Ministry Registration Form (Nursery)
Child's First Name
Name Goes By
Child's Last Name
List any known allergies / food allergies your child may have:
List any medical conditions or physical limitations your child may have:
Mother/Guardian Phone #
Father/Guardian Phone #
Provide the first and last name of other people who have your permission to pick up your child (this includes older siblings):
Are there any learning or educational concerns that would help us serve your child better?
I give permission for my child to be photographed for possible use in church media and printed materials.
Please do not photograph my child.
By typing your name you are electronically signing this form.
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